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HomeMy WebLinkAboutSpruce Lodge_56000110076000_Shoreland Permits_FOK SITE PEHIVilT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218) 739-2271 • FERGUS FALLS, MN 56537 WHITE-Office • GOLDENROD - Inspector YELLOW .Owner PINK - Assessor y^5/7Permit No,LEGAL DESCRIPTION BLUFF ZONEAND □ YES / gl NO LOCATION J -fAe.Ye^S^ toA LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME /<S ^s-hav !Y Ids'0*/f(S^r? PARCEL NUMBER (S)SfWOTNG / FILLING FIRE NUMBERi' JSf YES □ NOAJt r Zj 67fcTc/wtS -# OF CUBIC YARDS54 ■ - coo ~ N -ac^ 7- coC cic^IDENTIFICATION: Please Print All Information TELEPHONE NO. Last Name First Mailing Address — No. Street, City, State, and Zip CodeInitial (Daytime) Property Owner //.r.dcy A7. (^ n Derd- /y/l/ 5g-/ ^c5-v<r;?6NameContractor State Lie. # PROPOSED PROJECT (K) New Structure(s) ( ) Additlon(s) ( )MH/RV______________ PROPOSED USE ONSITE WATER SUPPLY^^]^lndividual ( ) Public None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM ^j^^lndividual Permit #_____ ( ) Collector Permit #_____ ( )OTLSD* ( ) Dwelling ^Non-Dwelling ( ) Water Oriented Accessory Structure (WOAS)YEAR CHARACTERISTICS OF NON-DWELLING ( ) Utility Structure HARACTERISTICS OF WOASCHARACTERISTICS OF DWELLING Ort Detached Garage ( ) Screen Porch(loathouse(\) Dwelling ( ) F^Bdacemenl Dwelling ( ) Additibqto Dwelling ( ) Existing Dw8(ling shall be removejLdit or before. Outside Dimension ( ) Basement __ ( ) Walkout/^ ( ) Ahadfted Garage ( ) Utility Structure( ) Gazm( ) Other Outside Dimension iS 0 Ft. X .Ft,( ) Other Outside Dimension3^0 -t Ft.& Ft.Ft. X Ft.Lotline Setbacks .Ft. 15Lotline Setbacks .Ft.Ft.&.Ft.OHWL Setback Lotline Setbacks .Fr .Ft. OHWL Setbj Ft.Bathroom: ( )Yes (^ ) No (If Yes / a complying Sewage System Required) Maximum Height / Ft. / story Ft.OHWI rackTotal^drooms .Maximum Height / 35 Ft. (2 story)Maximum Height / 10 ft. (1 story) /*3 ^ df/-- i/j8_ f ,Sq. Ft. Impervious Surface Ratio .%,Sq. Ft. Impervious SurfaceLot Area 3 ' -7-Ft. (3’ minimum)Ft. Elevation of lowest floor above OHWLWater Frontage / rAol_.Ft. Slope of lot /a.%Structure setback to right-of-way lo Ft. (10’minimum) (Sewage System Permit required before installation). Ft. (20’minimum) (Sewage System Permit required before installation). Ft. (10’minimum) (Sewage System Permit required before installation). Structure setback to septic tank Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System 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 condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed. * This permit is only valid after verification from the O.T.L.SD. that a conforming sewage system will be installed to service this lot... Contact Rollie Mann at 864-5533. ^/-/- rr V- /s - Dated: Signature of Dated: Land & Rd^urce Management Office RECEIPT NO.PERMIT FEE $ Comments: Form No. BK — 0597-002 290.821 • 'Victor Lundeen Co., Pririters • Fergus Fails, MN • 1-600-346-d870 APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 • FERGUS FALLS, MN 56537 WHITE - Office , GOLDENROD - Inspector YELLOW - Owner PINK - Assessor Permit No. ' “'7^ « c' i ' ^ 7 ' i 3 A ^ c 3 Y A. y/LEGAL DESCRIPTION BLUFF ZONEAND □ YES □ NO LOCATION / JJ-g::A 't CJ/>!r O tr't' fj <. SECTION TWP NO.RANGELAKE/RIVER NAME LAKE/RIVER CLASS TWP NAMELAKE NUMBER /^4'c.^ ^/3r/yJtr^'' GRADING / FILLING d YES # OF CUBIC YARDS _ □ NO/JfT /j PARCEL NUMBER (S)FIRE NUMBER b4 - 000 ' /V ^ oo 9 7 ooO Cl7eIDENTIFICATION; Please Print All Information TELEPHONE NO. Mailing Address — No. Street, City, State, and Zip Code (Daytime)First InitiaiLast Name Property Owner /-7 „/:/7<R -21ZZXIA De^-r ~~frzs7i&NameContractor state Lie. # ONSITE WATER SUPPLY ( ) Public a) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM ) Individual Permit #, ( ) Collector Permit #_ ( )OTLSD* PROPOSED PROJECT ('*) New Structure(s) ( )Addltlon(s) ( )MH/RV______________ PROPOSED USE ( ) Dwelling (>4 Non-Dwelling ( ) Water Oriented Accessory Structure (WOAS) J^lndividual YEAR CHARACTERISTICS OF WOAS ( ) Boathouse ( ) Screen Porch CHARACTERISTICS OF NON-DWELLING (V) Detached Garage CHARACTERISTICS OF DWELLING ( ) Dwelling ( ) Basement ^ ( ) Replacement Dwelling ( ) Walkoutx^ ( ) Addition to Dwelling ( ) AttaCifed Garage ( ) Existing Dwelling shall be removed'dfTor before X ^t. X ( ) Utility Structure ( ) Utility Structure( ) Gazebo( ) Other Outside Dimension 2 L_____Ft. X .Ft.( )Other. Outside Dimension Outside Dimension.■'■'Qd -t Ft.& 300 i- Ft..Ft.Lotline Setbacks .Ft. 7^.Ft.Lotline Setbacks_^.Ft.&.Ft.OHWL Setback .Ft.Lotline Setbacks Fr OHWL Setback'..Ft.Bathroom; ( )Yes (X )No (If Yes / a complying Sewage System Required)OHWL,,Selfcack Ft. Total Bedrooms Maximum Height / 35 Ft. (2 story)Maximum Height /10 ft. (1 story)Ft. storyMaximum Height <^S7 C ^ d..ji .%.Sq. Ft. impervious Surface Ratio.Sq. Ft. Impervious SurfaceLot Area .Ft. (3’ minimum).Ft. Elevation of lowest floor above OHWLWater Frontage .%__________Ft. Slope of lot .Ft. (10’mlnlmum) (Sewage System Permit required before installation). .Ft. (20’minimum) (Sewage System Permit required before installation). ,Ft. (10’minimum) (Sewage System Permit required before installation). Structure setback to right-of-way. mStructure setback to septic tank_____________ Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System 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 condition that the person to whom it is granted, and his agent, employees and workmen shall conform In all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed. * This permit is only valid after verification from the O.T.L.SD. that a conforming sewage system will be installed to service this lot... Contact Rollie Mann at 864-5533. ■ 7Dated: Signature ofJ)jsrnei;^ V /sDated: Land & Resound Management Office/ 7)7.9-7^RECEIPT NO.PERMIT FEE $ Comments: 290.621 • Victor Lurtdeen Co . Printers • Fergus Falls. MN • 1-800-346-4870Form No. BK — 0597-002 INSPECTION RESULTS Make all measurements and computations Zoo*'Structure Set Back frotrt Ordinary High Water Level Ft.Ft. IStructure set Back from Top of Bluff Ft. Ft. Structure Set Back from Road Right of Way Ft.Ft. Ft.&^^ Ft.Structure set Back from Lot Lines R.&Ft. Structure Height Ft.Ft. Structure Set Back from Septic Tank Ft.Ft. iC/f'Structure Set Back from Absorption System Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level____________________Ft.Ft. Land Slope at Building Line %% Inspector’s Comments / Sketch:,i i ! J 1Trss ^ So^26 5o^ So* sL sU^ It Inspector's Signature Date o1 Inspection Time of Inspection ^ ^ GRID PLOT PLANinch(es) equals 33 feet SKETCHING FORMLScale:.grid(s) equals feet, or , 19 ff ■Dated: Signature Please sketch your lot indicating setbacks from road right-of-way, lake, sideyard and septic tank and drain- field for each building currently on lot and any proposed structures. 6 6 Ccvl 1 281.949 • Victor Lundeen Co. Printers • Fergus Falls. MN • 1-800-346-4870MKL — 0871 — 029 , GRID PLOT PLANinch(es) equals / O feet SKETCHING FORM£Scale:.grid(s) equals feet, or ^ .7 -7V.y-, 19 ff-Dated: Signature Please sketch your lot indicating setbacks from road right-of-way, lake, sideyard and septic tank and drain- field for each building currently on lot and any proposed structures. Hi rti i .0 -___0 A K• -2^ -V ^------ <00 t I 1 ” O (VJo 3- V 4 1 4 o 0 0 0 O 281.949 • Victor Lundeen Co. Printers • Fergus Falls, MN • 1-800-346-4870MKL — 0871 — 029 ), „ GRID PLOT PLANinch(es) equals 33 feet SKETCHING FORM.. .:_^iIScale: i .grid(s) equals:.feet, or 1? .19^,Dated: Signature Please sketch your lot Indicating setbacks from road right-of-way, lake, sideyard and septic tank and drain- field for each building currently on lot and any proposed structures. , . r : -h: j. T - I- ■*r MKL C. (/./3-99 aJSAJc/T ^ ~ 7- AS yoy ^Vs^ 1^ ■!0=. ^ 3<^Q> 3-DX^^< !■C5 3/14 ‘iijiSvS- ~ ^/ol - ^IjeJ -^ ^ ^“/y^c J1oV\. White - Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone; (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Permit No..LEGAL DESCRIPTION / AND LOCATION TWP NameSec.TWP RangeLake Classif.Lake No.Lake Name IDENTIFICATION; Please Print All Information Tel. No.Mailing Address— No. Street, City and State Zip No.Last Name InitialFirst Owner AlJiJ NameContractor Architect Name. TYPE OF IMPROVEMENT:NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE: Family Dwelling ( ) Multiple Dwelling ( ) Other \Building ( ) Alteration Specify;, Units ( ) Other Size ESTIMATED COST OF IMPROVEMENt|$ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL; ( ) Public ^^^^^ndividual Septic Tank WATER SUPPLY: ■' ( ) Public ^^t><)^lndividual Well DIMENSIONS: ...I^No ( ) Masonry ( ) Wood Frame .i^<][^tructural Steel ( ) Other — Specify Basement: ( ) Yes Stories above basement: Sq. feet (outside dimension) Bedrooms ............................. , etc. IBaths Type of Roof: CHARACTERISTICS: ,TsrH m..sguare-feetr A9:hr^..Water frontage is feet.Maximum depth of lot feet.Lot Area is /QO -FBuilding 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. (Building Line) 3:±feet ,r'2..<2.feet — from road right of way is feet. Ml Mand feet. M.feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). Structure will be located -hzaStructure 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 herewitf 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 STA TE STA TUTES.Signature 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. Lr /fg-S/7.^,y). Dated Shoreland Management Official z>oPermit Fee $.I Comments: 195676(@ VICTOR LIJNOEEN CO.. PRINTERS, FERGUS FALLS. MINN.Form No. MKL-0771-002 White - Office Yeiiow — Owner Pink — A«ee»orGoldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT ' 7 / Permit No,./LEGAL Id Tr.-).J V- )cJ e- V'DESCRIPTION t ’ AND LOCATION /</ / '-^ /7 TWP NomeLeke Cleisif.Sec.TWP RangeLake No.Lake Name IDENTIFICATION: Please Print All Information Tel. No.Last Name Zip No.First Initial Mailing Address— No. Street. City and State Owner NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: /( ) One Family Dwelling ( ) Multiple Dwelling ( ) Other ( ) New Building ( ) Alteration Specify;. '' o' 0 Units ( ) Other Sizer ESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL;DIMENSIONS: ( ) Masonry ( ) Wood Frame (X) Structural Steel ( ) Other — Specify ( ) Public ( I Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( Individual Well Basement: ( ) Yes ( ') No Stories above basement: Sq. feet (outside dimension) Bedrooms Baths Type of Roof: CHARACTERISTICS: ;L..square feet. Water frontage is ..... Building set back from high water mark is..................... Land height above high water mark at building line is, Building set back from State highway right of way Side yard is Structure will be located feet.Maximum depth of lotLot Area is feet. feet. (Building Line) t feet /feet — from road right of way is .feet. feet.and lU. .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 herewitf 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 SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUTES.Signature of Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit: express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. /./ / i../ /Dated K-' Shoreland Management OfficialC■CPermit Fee $./ ‘/■ ' L- Comments: > i I9S676® VICTOR LUISIDEEN CO.. PRINTERS, FERGUS PALLS. MINN.Form No. MKL-0771 002 \ INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS jr MINIMUM Shall Be j.Sq. Ft Lot Area (Square feet)Sq. Ft.Sq. Ft. Water Frontage Ft. Ft. [Do Ft.HOBuilding Set Back from High Water Mark Ft. Building Set Back from State Highway 50 Ft.Ft. 9^?^ FtBuilding Set Back from Street or Road Ft. /S &l ^ Ft.Side Yard /o /oRear Yard Ft.Ft. it Occupied Building to Septic Tank 10 Ft. Occupied Building to Absorption System 20 Ft. Elevation at Building Line above High Water Mark_____________5 Ft.3 Ft. Inspector's Comments: f0 7Y. 6 'f Title m 0 5Inspection Dated 19 0 Agency \ vieran lumccm « «• . miintim. rcMwt falls, mhis. Scale: Each grid equals feet/inches GRID PLOT PLAN SKETCHING FORM 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. si/' X !1 I 5\ c? ll1 7 < /s ■X -<*«• §k 21598 7@MKL-0871-029 VICTOR LUNOetN CO . PRINTERS. PERGU8 FALLS. UINN. Department of LAND & RESOUI^CE MANAGEMENT COUNTY OF OTTER TAIL Phone 218-739-2271 Court House Fergus Falls, Minnesota 56537 MALCOLM K. LEE, Administrator September 6, 1985 Floyd Felton 205 Reno Ave Canby, MN 56220 Dear Mr. Felton: While inspecting along Star Lake a 14' x 76' mobile home was noticed on what appears to be your property. The Otter Tail County Shoreland Ordinance requires a site permit for this mobile home. What is the site permit number? For your information, I have enclosed our ordinance, setback requirements, fee schedule, and also a site permit application. If you have any questions please contact our office. Please respond to this letter within ten days of receiving it. Thank yoq, ih Robin Inspector enc mgb SHORELAND MANAGEMENT ORDINANCE - DIVISION OF EMERGENCY SERVICE - SUBDIVISION CONTROL ORDINAwrF SOLID WASTE ORDINANCE LunuiixjANCb SEWAGE SYSTEM CLEANERS ORDINANCE - RECORDER, OTTER TAIL COUNTY PLANNING ADVISORY COMMISSION RIGHT-OF-WAY SETBACK ORDINANCE FUEL AND ENERGY COORDINATION r White — Office Yeiiow Owner Pink AssessorGoidenrod SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Inspector ci OS S'PiV^uCC Lo{i^ Permit No..LEGAL DESCRIPTION <AND LOCATION Lake No. Lake Name Lake Ciassif.TWP NameTWPRangeSec. IDENTIFICATION: Please Print All Information Tei. No.Zip No.IVIaiiing Address— No. Street. City and StateLast Name initiaiFirst fofi ^ Floyd £€r>o Ai)^ -5<^2ZCOwner Cqyij^y , /h/U NameContractor' Architect Name. NON-RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE: (/X.New Building ( ) One Family Dwelling ( ) Multiple Dwelling Specify:, /f Units( ) Alteration 3o X QpO( I Other ( ) Other Size ESTIMATED COST OF IMPROVEMENTIS PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Yes NoI ) Masonry ( ) Wood Frame ( I Structural Steel (^X-Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well Basement: Stories above basement: Sq. feet (outside dimension)5-kef BathsBedroomsno IType of Roof: CHARACTERISTICS: IQ.Q.2D..mD.square feet. Water frontage is Building set back from high water mark is....... feet.Maximum depth of lot feet.Lot Area is /• feet. (Building Line) 3.Land height above high water mark at building line is Building set back from State highway right of way.... Side yard is feet :2.o5:.o feet — from road right of way is feet. 1.0oand feet. feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). Structure will be located M...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.Slgnaturg,.^Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Permit: , on Dated Shoreland Manager^nt Official Permit Fee $. Comments: 19S676(vl) VICTOR LliNDEE.N CO.. PRINTERS. FERGUS FALLS. MINN.Form No. MKL-0771-002 White — OfficeYeilow ^ Owner Pink <- Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT i\ t ! U / f V 7 1 Permit No..\ -(< YLEGAL\ I n i! e J.DESCRIPTION r OS > ( f1(f ' v " ’ o / ■€.1-A .(AND LOCATION /7c L/ / Sec.TWP Renge TWP NomeLake No.Lake Classif.Lake Name IDENTIFICATION: Pleaee Print All Information Last Name Mailing Address— No, Street. City and State Zip No.Tel. No.First Initial 17Owner’ ■■y.i NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: i'( ) New Building ( ) Alteration ( ) One Family Dwelling I ) Multiple Dwelling »■Specify:, , /Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPR0VEMENT|$ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: f'N ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well ( ) Masonry ( ) Wood Frame ( I Structural Steel ( ) Other — Specify ( ) Public Basement: ( ) Yes ( ) No Stories above basement: Sq. feet (outside dimension) Bedrooms i I i: F I Bathsn 0 h ^ (Type of Roof: CHARACTERISTICS: /O......V7. square feet. Building set back from high water mark is. Water frontage is feet.Maximum depth of lotLot Ares is feet. feet. (Building Line) Land height above high water mark at building line is Building set back from State highway right of way..... Side yard is 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.)..•r.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. TW/S /S A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STA TE STA TUTES.Signature of Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Permit: -sS7r' I >' t- / ■ / / I, i CDated v ec Shoreland Management Official Permit Fee $. Comments: a_L_LSDKC'i 195676(g) VICTOR LUNOECN 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)1Sq, Ft.Sq. Ft, Water Frontage Ft.Ft. Building Set Back from High Water Mark Ft.Ft. Building Set Back from State Highway 50 Ft.Ft. Building Set Back from Street or Road 40 Ft.Ft.s Side Yard &Ft.&Ft. Rear Yard Ft.Ft. Occupied 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: Inspector's Signature Title Inspection Dated 19 Agency VICTO* LUNMCt) « 0*.. MlVICB*. r(MV* f«U.a. HINN. ! SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 — Fergus Falls, Mn. 56537 APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY Office Yellow ^ Owner Pink Goldenrod — Inspector Assessor 3/ 'itc^ j:Lu^Permit No.LEGAL Date.DESCRIPTION 7* AND LOCATION H /3sr- V7 5~Tarn TTa G D Sec.TWP NameLake No. Lake Classif.TWP RangeLake Name IDENTIFICATION: Please Print All Information Last Name Initial Mailing Address— No. Street. City and StateFirst Zip No.Tel. No. ^/CAJiTSy -3~5/^/2-'>Tjeyh'2yLO,Owner PiTAJr Sfi/n ENameContractor bArchitectName. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ( ) New Building (^.J^lteration ( ) Other_______ ( ) One Family Dwelling Specify:. () Mul^plej^^lling^^^Units (UOther Size ESTIMATED COST OF IMPROVEMENTS S~Q Q (omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL: (pf^blic (i<<1^ndividual Septic Tank, etc. WATER SUPPLY: DIMENSIONS: (LrYes ( ) No( ) Masonry (f,-1^ood Frame ( ) Structural Steel ( ) Other — Specify Basement:/ Stories above basement: Sq. feet (outside dimension) Bedrooms .............................I( ) Public (L^dndividual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes { ) Central Baths HEATING: (U+^lectric ( ) Gas ( ) None (-^oType of Roof:( ) Oil (-VNo ( ) Coal Other:( ) Unit CHARACTERISTICS: / 00Lot Area is square feet.Water frontage is , feet. (Building Line) ...............................feet feet. ZLs:..Building set back from high water mark is Land height above high water mark at building line is Building set back from State highway is Side yard is.......... Building will be located....... Building will be located L VOafeet — from road or street is feet. V.2.:2 i7 feet. Rear yard is ... feet from septic tank (Sewage System Permit must be obtained before installation). ... feet from soil absorption system (Cesspool, Drainfield, etc.). ... and feet. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Signature of Own^i^ Dated. 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. >1 Shor^nd Management Offici^j/ ec- - /2o > 7y\cu^ /9 /.VxDated L VsPermit Fee $ r-D. 0<5 State Surcharge $. ,A 'IZ (AitComments: i Form No. MKL-0771-002 158899 VICToa LUH»ICH • CO.. PKIHTtC*. fCMflUl fACLi. HIMH White/— Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELAIMD MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 - Fergus Falls, Mn. 56537 APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY Permit No„LEGAL Date.DESCRIPTION AND LOCATION Lake No.Lake Name Lake Classif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address— No. Street, City and State Zip No.Tel. No. Owner NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling ( ) Other Specify:, Units ( ) Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public I ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes I ) Central Basement: ( ) Yes ( ) No Stories above basement: Sq. feet (outside dimension) Bedrooms Baths HEATING: ( ) Electric ( ) Gas ( ) Coal Other: Type of Roof:( ) No ( ) Oil ( ) No ( ) None ( ) Unit CHARACTERISTICS: Lot Area is square feet.Water frontage is. feet. (Building Line) ...............................feet feet. Building set back from high water mark is................... Land height above high water mark at building line is Building set back from State highway is........................ Side yard is.................... Building will be located Building will be located feet — from road or street is feet. .......................................feet. Rear yard is feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). and feet. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Dated, Signature of Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit: express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Dated Shoreland Management Official Permit Fee $.State Surcharge $. Comments: not called PILED4-'20 XZ. Form No. MKL-0771-002 ,158899 VICrOK UIHSCtH 4 C«.. PBIHTtllt. FEB«U« r«.I.S. J i: INSPECTOR'S CHECK LIST Make all measurements and computations MINIMUMShall Be 1 Sq. FtACTUAL IS X Sq. Ft.Sq. Ft.Lot Area (Square feet) Ft.Ft.Water Frontage Ft.Ft.Building Set Back from High Water Mark 50 Ft.Ft.Building Set Back from State Highway 40 Ft.Ft.Building Set Back from Street or Road Ft.&&Ft.Side Yard Ft.Ft.Rear Yard 10 Ft.Ft.Occupied Building to Septic Tank 20 Ft.Ft.Occupied Building to Absorption System Elevation at Building Line above High Water Mark_____________3 Ft.Ft. Inspector's Comments: Inspector's Signature Title Inspection Dated 19 Agency VICTOK LUNOCIH t C« . rALi